Permit C ITY OF TIGARD ELECTRICAL PERMIT •
r.
�` s4, ELECTRICAL
#: ELC2005 -00643
, 'Il DEVELOPMENT SERVICES DATE ISSUED: 9/1/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S135AB-01004
SITE ADDRESS: 10220 SW GREENBURG RD 120 ZONING: C - P
SUBDIVISION: LINCOLN CENTER/TWO LINCOLN LOT : JURISDICTION: TIG
Project Description: (5) branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: •
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 4 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
EQUITY OFFICE PROPERTIES TRUST WILLAMETTE ELECTRIC INC
ONE SW COLUMBIA #300 PO BOX 230547
PORTLAND, OR 97258 TIGARD, OR 97281
Phone: 503 - 639 - 8865 Phone: 503 - 624 - 3631
FEES Reg #: LIC 75059
Description Date Amount SUP 1965S
ELE 34 -283C
[ELPRMT] ELC Permit 9/1/2005 $73.45
[TAX] 8% State Surcharge 9/1/2005 $5.88 REQUIRED ITEMS AND REPORTS
Total $79.33 •
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: /f' ittis J P2 Permittee Signature: _
OWNER INSTALLATION ONLY •
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
. Approved plans are required on the job site at the time of each inspection.
AUG 31 2005 3:43PM HP LRSERJET 3200. p. 2
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E ! Le tr cal.Per Applicaiti,®lt
° ' , , FOR OFFICE, USE t'31�`L1' •
of Tigard rd. i t e c.. v c i / n �
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ate1B .�tJ�' Permit No �J C�I��.(/� (/b s
1312` ; 1t. 1rsi1• .lvd., Tigar i, OR 97223 r � f P:.ta Review '
Phone: 503.639.4171 Fax: 503.598.1960 AUG " 1 1 7'0 ',,, 1 A Da tel3 : Other Permir. •
Inspection Line: 503.639.4175 ` .4-1 14 .. Date 'Ready/By: Tutu )� 8 See Page 2 for
Internet: www.ci.tigard.cr.us NoliftediMethod: TI If (I Supplemental Information
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❑ New construction hi Addition /alte ration/repiacement Please deck all that apply:
❑Service over225 amps, comm'1 ❑Hazardous location
❑ Demolition ❑ Other A+ , ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq ft.;
Ap 141 4 W 1 11 t 4t ' 1Wk - ' Z' t rY , I !. S �,t W t' 6 '1 I gti
„,, t , t I s t . n - ,,, ,i' t t , e f ) ,, f s s' , FI . h + ' ' +fx of t- and 2- family dwellings 4 or more new residential
Sa4.. ".1:14- �i...mci -are 1 ?�. :,trill. r.olb w -:r., ,is i_ - ,. :. •Na iciV ... alt a:I I�h'it.li .
❑ 1 - and 2 family dwelling 4 Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ['Feeders, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other: Manufactured structures or
' X l0 _,, . ,�� t ¢ ', a ,� x . ❑Occupant load over 99 persons ❑
;{( ` t tP:i%i la 1;� fk c tai! r i a e� { 1 - #1 si' - 7" �, `,I htlW: ❑EgreSSlligl]t p1 RV park
$rte "IIKI . :?�, ' , :iii t ile3..rsl..: 51 . iiilS.-I .at ,di?.c,ui ter__ S•.S(3a,, v'f3tti'9 ',tt5...Lhills ..4; :i. , e.: t 1.. ['Other:
no.: Job site address: z S� ,�mo.�tt 1 ❑Health care facility
�j' �i / Z(J WA1 v as. f 1 Submit 2 sets of plans with any of the above.
City/State/ZIP: J The above are not applicable to temporary construction service.
i s Y9JL ry E 9 F �'
�i ,K. � ,i�'l"f° l.i9etns w.
Suite/bldg. /apt. no.: i Project name: Aj (i/ C../...v d ' hi •.
/ 5 t7 t Descriplten Qty. 13ee. Total
Cross street/directions to job site: ffff �J New residential single- or multi- family dwelling unit.
Includes attached garage.
2. L.1 4J S✓ I tO 1,000 sq. ft. or less 145.15 4
Subdivision: l Lot no.: Ea- add'I 500 sq. ft or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: # t i Limited energy, non - residential 75.00 • 2
i 'yu ` l G S ! if 7 i72l id g CVI " �r lilt `•` N ligi i 6 ( r i 'i l f i s + 'l it �' "� ' ig4 .
; 4 '!cif`1:1 _eV4iiicifibl_.I�k ' _. 1.;Alli, . :twit, step ll ,x. :lt a'Pae `` f;..r t tt >n4 . '' ; g'_ +• E ach m anu factur e d or m o dul ar
/ � / _ .(� dwelling, service and /or feeder 90.90 2
. t :-•-... Ct/ i lei t Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
to a •^m a S` iP f i l ;1n- n '^ d t ? ''r iPi p 20.
. �° �,� � � � � t P, � �, ,,, -a,� �,� � � : . p , 201 amps to 400 amps 106.85
= 1i ' ! i,:k t, II l' lJ i!•td�'S)' a { � Ie , 1#' 4' lA 1 11.1 : 1v., :' 'S 0,' , ` 4 "- , 7-1.:'....*-' i as l�,���n�.,,��,- .,inn. E. s�:+ r ...r...,3.lk..,ti.,....0 9'tl,� ..n.t., '�tT 401 amps to 600 amps 160.60 2
Name: it) P L f a..J CG'uL/i,--_ 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
it i Y .fT y a. ; {'ri o 4 R i 11't A'4'' ,` "'F� pi' it r" �R,'�-V} y n t inr v3 miyt �F.;= i,ai, A. Fee for branch circuits with
ear l;li l' lri 'i tl ,k t•..ar.:.'eites2 b a a.ilim.. N -{ : l � �a�3 ifs ' f . .. 4.4, 1 , f l,„4 °. 4N
.}u x ..,s om, F, - service or feeder fee, each
6.65 2
Business name: • branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, i g S 2
each branch circuit ! 46.85 4/ ^_
Address: Each add'1 branch circuit if I 6.65 2 teL. 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: ( ) Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or limited- .
- xx'� ors sjn ap ;, r•T,� •- n st to '6 , i sHar s 4I 1� °""1s ' N e'. energy Panel, alteration, or
I�,li €H� r`�ic s a=,.L' � "tqv 31s,a roa - life,. , .,.�:. ,ii - .,o,a =4 :iri s PyP
extension: Describe: Page 2 2
Business name: I,ti ! it k e -eP /.•'� ,, /1 IC (r. 4-
Each additional inspection over allowable in any of the above
Address: p ( ,� z...1 0 s.-- Per inspection 62.50
City /State /ZIP: T 201 (}, . 9 2." I Investigation OCT hour (1 hr min) 62.50
( � ) (2r& �1 y I Fax: (571 ) Z - 2 ' Industrial plant per hour 73.75 •
Phone: ( a ' r e ! a O ?: 4 ME,�, ;?.f r
CCB Lie.: 3 5-e. I Electrical Lic.: pi. 76-3 L Suprv. Lie.: (9 S Subtotal s if
Suprv. Electrician signature, required: c----f-----)1e- Plan review (25% of permit fee)
Slate surcharge (8% of permit fee) r kg' i / iw
Print name: }� Date: � ^ � � i
� s TOTAL PERMIT FEE
C « !
Authorized signature: Thle permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building industry Service Board '
"' Number of inspections per permit allowed.
dBullding0 'emtitssELC- PermitApp.doc 12/03 440 -461 iTO WIZ /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200&.00643 1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/1/2005
Phone: (503) 639 -4171 �����I11
Inspection Requests (2 Hrs.): (503) 639 - 4175 L,.
INSPECTION WORKSHEET 5p DATE: 9/6/2005 TIME: 7 : 06AM PAGE: 48
SITE ADDRESS: 10220 SW Pa NBURC RD 120 CLASS OF WORK:
SUBDIVISION: LINCOLN CEN • *MVO LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: NORTHWEST M►'•TCACE
DESCRIPTION: (5) branch circuits.
OWNER: EQUITY OFFICE PRO " RTIES TRUST, PHONE #: 503 - 639 -8865
C ONTRACTOR: WILLAMETTE ELECTRIC #,NC PHONE #: 503-6243631
Inspection Request Scheduled For: Date: 9/6/2005 Pour Time:
Code # Inspection Description onfirm # Contact # Message
199 Electrical final 0 953-02 971-219-0413 N
Corrections /Comments /Instructions:
(Z.0)ot. CVW--11 \ gi■il_-, G cAkti)
1
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL ❑ CAL O' INSPECTION ❑ ADDITIONAL FEES ASSESSED
31151 Inspector: ���� / Date: Phone #: (503) 718 - Z1 Ni